AMA Journal of Ethics®

Illuminating the art of medicine

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. May 2011, Volume 13, Number 5: 269-330.

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May 2011 Contents

The Country Doctor

Ethics Poll

Country doctors have been portrayed in novels, film, and television as kindly, understanding people who put the welfare of patients before their own comfort, make house calls at any time of day or night, and share the lifestyle of those they treat. Which of the following best expresses your opinion of that image?

There is some truth to the image. Physicians without those qualities generally do not choose to forgo the cultural amenities of urban or suburban life to practice in rural settings.

This image of the country doctor had some truth to it in the days when the doctor's principal role was sitting and talking with the sick and dying. It is not true now, in the day of definitive diagnostic tests, effective pharmaceutical treatment, and high-tech interventions.

The romanticized image of the country doctor described above never had any basis in reality.

Many rural areas in the U.S., designated as Medical Professional Shortage Areas (MPSAs), do not have the number of primary care physicians they need to serve the population. How do you think this maldistribution of physicians should be redressed? (Check all that apply.)

Medical schools should identify college students who want to become physicians in rural areas and offer special programs to help them succeed in medical school and train them for rural primary care practice.

Expand telemedicine links between MPSAs and urban health science centers that have the physician resources needed in rural America.

Institute certification programs for nurse practitioners and physician assistants that equip them to perform a broader scope of medical services.

Offer more scholarships and loan repayment programs for medical school graduates in return for service in MPSAs.

Make no attempt to alter physician distribution; to do so is social engineering and not the American way.